Background and Rationale

MESA will provide important new information about the pathophysiology of subclinical disease development and progression and its role in clinical cardiovascular disease. The study has the potential to identify new risk factors and, therefore, increase the ability to predict cardiovascular disease and, ultimately, to design new interventions to prevent cardiovascular disease. The ethnic diversity of the cohort is a major strength of the study, allowing comparisons that may provide unique insights about new risk factors and subclinical disease and allowing the possibility of ethnic-specific preventive strategies to be explored.

Results of the study will be applicable to clinical practice by identifying noninvasive subclinical disease measures that best predict risk and by suggesting new approaches to intervention to prevent progression of subclinical disease and prevent conversion of subclinical to clinical disease. Some findings may be directly applicable to clinical practice, others may be used to design clinical trials or optimize interventions, and still others may lead to research resulting in new methods of intervention.